chlorothiazide

Chlorothiazide

Dose: 10 to 20 mg/kg/dose PO
1 to 4 mg/kg/dose IV

Frequency: Q 12 hours

Comments: Chlorothiazide is a thiazide diuretic used to produce diuresis and for the treatment of hypertension. Thiazide diuretics act on the proximal portion of the distal renal tubules to prevent reabsorption of sodium. They are not as effective as "loop" diuretics such as furosemide. At maximum doses, the effects of the different thiazide diuretics are essentially equal. Peak effects are seen in 2 to 6 hours. Unlike furosemide, an increase in calcium excretion does not occur; however, with chronic use both a potassium and magnesium deficiency can develop. When used with furosemide, hydrochlorothiazide exhibits a synergistic effect that can cause a significant loss of fluids and electrolytes. Further comments of chlorothiazide.

Toxicity: The most commonly reported problems include hypokalemia, hyperglycemia, hypercalcemia, hypophosphatemia, and hypomagnesemia. Adverse effects associated with chlorothiazide.

Preparation:
PO: Chlorothiazide (Diuril) is available as a 250 mg/5 ml suspension. The oral suspension contains saccharin, 0.5% alcohol, and sucrose. Refrigerate.

IV: Chlorothiazide (Diuril) is available in a 500 mg vial. Add 18 ml of SWFI to reconstitute. This results in a 27.8mg/ml concentration (28mg/ml if the pharmacy computer rounds it up to a whole number). Compatible with dextrose or sodium chloride solutions. Stable at room temperature, discard after 24 hours.

Compatibility: Not compatible with TPN, compatibility with filter is unknown. It is compatible with D5W, D5 with sodium chloride, D10, LR, 0.45% sodium chloride, and NS. It is also compatible with lidocaine, nafcillin, ranitidine, and sodium bicarbonate. Incompatible with amikacin, insulin, morphine, and vancomycin.

**Chlorothiazide 50 mg/ml concentration and an oral dose of 1 mg/kg**
Weight	Dose (ml)	Weight	Dose (ml)
500	0.10	3000	0.60
750	0.15	3250	0.65
1000	0.20	3500	0.70
1250	0.25	3750	0.75
1500	0.30	4000	0.80
1750	0.35	4250	0.85
2000	0.40	4500	0.90
2250	0.45	4750	0.95
2500	0.50	5000	1.00
2750	0.55	5250	1.05

**Chlorothiazide 28 mg/ml and an IV dose of 2 mg/kg**
Weight	Dose (ml)	Weight	Dose (ml)
500	*	3000	0.21
750	*	3250	0.23
1000	*	3500	0.25
1250	*	3750	0.27
1500	0.10	4000	0.29
1750	0.13	4250	0.30
2000	0.14	4500	0.32
2250	0.16	4750	0.34
2500	0.18	5000	0.36
2750	0.20	5250	0.38

* For infants less than 1.5 kilogram, add 9 ml of sterile water to 1 ml of the 28 mg/ml suspension. This gives a concentration of the drug of 2.8 mg/ml. If using a 2 mg/kg dose, the infant's dose would then be: wgt (kg) x 0.7 ml/kg which was derived from [wgt (kg) x 2 mg/kg � 2.8 mg/ml]. Use once and discard.

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